Do you have pain in the middle of your chest? Let's get to know the Sternum!

Do you sometimes feel pain, tightness, or tightness in the middle of your chest? To be precise, it's that flat bone in the middle of your chest. When this pain comes, many people are afraid, "Is this a heart attack?" That fear is reasonable, but not all chest pain is a heart attack. There can be many other causes for pain in the middle of your chest. So today, let's talk about this important bone in the middle of our chest, the sternum, the reasons why it can hurt, and what we need to be aware of.

What is this Sternum? It means the middle bone of the chest.

Simply put, the sternum is the flat, T-shaped bone in the middle of your chest, at the front. Although we also call it "sternum" in Sinhala, most people know it as "breastbone" in common parlance.

This is not just a piece of bone. This plays a very important role.

Main functions of the sternum

• Providing protection: The sternum, along with the ribcage, is the main shield that protects the most sensitive and important organs in our body, such as the heart and lungs . It also protects the stomach, esophagus, and major blood vessels.
• Coordination: This is like the center point of our skeletal system. Our collarbone (clavicle) and the top six pairs of ribs connect to this sternum. It also connects to a number of muscles in the chest and upper abdomen.
• Aiding breathing: Although the sternum does not move directly, flexible cartilage, which connects the ribs to it, allows the chest to expand and contract slightly as we inhale and exhale.

What are the parts of the sternum?

If we look at this middle bone of the chest, it consists of three main parts. We can imagine it as a sword turned upside down.

1. Manubrium: This is the widest and strongest part of the sternum, located at the top. It resembles the hilt of a sword. Our two collarbones and the first pair of ribs attach to this part.

2. Body: This is the middle, longest, and flattest part. It looks like the blade of a sword. The ribs from the third to the seventh rib attach to this part.

3. Xiphoid Process: This is the small, pointed part at the bottom of the sternum. It looks like the tip of a sword. When we are young, it is mostly made up of cartilage. As we age, it gradually turns into bone (calcifies). Some people may feel this part as a small lump when they touch it.

Why does this middle rib bone hurt? The main reasons

Okay, now we come to the most important part. There are many reasons why pain can occur in the area of ​​the sternum. Some are related to the bone itself, some are related to the surrounding muscles, cartilage, or joints. Other pains come from problems with other organs in the chest, but we feel them in the center of the chest. Let's look at these reasons in a table.

What are the symptoms of each disease?

Now let's look at the symptoms you might experience in each of these conditions. Knowing these will also help you explain your condition to your doctor.

Costochondritis

• A sharp, stabbing pain in the center or on either side of the chest.
• The pain increases when you take a deep breath, cough, sneeze, or even move your chest slightly.
• When you press your finger on the painful area , it hurts a lot .
• Sometimes this pain can also spread to the arms and shoulders.

Sternal Fracture

• Severe pain that has been present since the accident.
• The pain gets worse when breathing or coughing.
• Swelling and bruising (blue discoloration) at the site of pain.
• Difficulty breathing.

Acid Reflux

• A burning sensation in the middle of the chest (heartburn) . As if on fire.
• This often increases shortly after eating or when lying down to sleep.
• A sour taste in the mouth or food coming back up the throat .
• Frequent urination.

Muscle Strain

• Pain that increases when turning the chest, lifting an arm, or performing any activity.
• Pain decreases with rest.
• Feeling pain when you tighten your chest muscles.

What are the treatments for this pain?

Treatment options depend on the cause of your pain. That's why it's important to see a doctor for a proper diagnosis . The doctor will examine you and, if necessary, order tests like an X-ray or ECG to determine the cause.

• For costochondritis and muscle strains: Rest is often the best treatment. Pain relievers (e.g., NSAIDs) and heat application to the painful area may be recommended.
• For a sternum fracture: Treatment varies depending on the nature of the fracture. For minor fractures, rest and painkillers are sufficient. However, for severe fractures, surgery may be necessary.
• For acid reflux: Lifestyle changes (e.g., reducing spicy, oily foods, stopping lying down after eating) and medications that control stomach acid (antacids, PPIs) are given.
• For infections: If it is a bacterial infection like pneumonia, antibiotics are given.

Is this a heart attack? How do you know the difference?

This is the biggest question everyone has. There are some differences between the pain associated with the sternum and the pain that occurs during a heart attack.

These are the most common symptoms of a heart attack:

• An unbearable pain or pressure in the center of the chest, as if it is being squeezed, crushed, or confined .
• This pain may spread to the left arm, shoulder, neck, jaw, or back .
• Difficulty breathing and wheezing.
• Excessive sweating (cold sweat).
• Feeling nauseous, vomiting , and dizzy.

In contrast, in a condition like ``costochondritis``, the pain is felt when you press on the painful area with your finger (which does not happen in a heart attack), and the pain changes when you move your body and breathe.

When should we definitely see a doctor?

If you experience any of the following, be sure to seek medical advice.

• If the pain occurred after an accident.
• If the pain increases day by day.
• If there are symptoms such as difficulty breathing, excessive sweating, and dizziness along with the pain (go to the ETU immediately).
• If the pain is accompanied by excessive vomiting or vomiting blood.
• If the pain does not subside even after taking regular painkillers.